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MANAGER, QUALITY – BEHAVIORAL HEALTH in Tacoma, WA at Beacon Health Options

Date Posted: 12/27/2018

Job Snapshot

Job Description

We are curreently seeking a dynamic QUALITY MANAGER to join us in our Tacoma, Washington office.  The Quality Manager is responsible for overseeing the internal and external quality activities, operationalizing the Quality Management (QM) program, and coordinating the Engagement Center’s participation in regional and corporate incentives and activities. Assists Engagement Center management in identifying areas for quality improvement, implementing policies, establishing and monitoring corrective action planning, and coordinating the implementation of enhancements to processes.

Position Responsibilities:

  • Serves as the primary lead in the development, operationalization and evaluation of the Engagement Center’s Quality Management plan including the application of Continuous Quality Improvement principles to conduct periodic assessments of program effectiveness. In collaboration with the Director of Quality, develops and implements an annual Quality Plan and Evaluation.
  • Develop and implement annual provider oversight and audit plan to ensure compliance with health plan/client specific delegation requirements in accordance to local, state, federal and NCQA requirements.
  • Responsible for Health Plan / client-specific performance improvement activities, and coordinating with the Quality Analytics team regarding data analysis related to such deliverables.
  • Represent Quality Department at Health Plans / client or other Washington specific meetings where current quality activities including outcomes are discussed or presented.
  • Contribute to NCQA and URAC accreditation activities and conduct research, reporting, and data analysis focusing on NCQA and URAC accreditation activities to ensure ongoing compliance with the accreditation standards.
  • Support completion and delivery of all Washington-specific reports and documentation; develop and implement procedures for reporting and delivery for overall and plan-specific report.
  • Represent Washington in the BEACON Quality Improvement Council (QIC) and QM/UM/CM Committee.
  • Contribute to the development of new Policies and Procedures or the revision of existing P&Ps as directed by the Director of Quality.
  • Collaborate with the Quality leadership team to oversee key departmental activities and to further departmental goals.
  • Participate in implementation of new contracts.
  • Assist in all areas of quality improvement throughout Beacon, including preparing and presenting staff trainings on issues related to Quality as part of Beacon’s Employee training program requirements.
  • Analysis of current processes and development of new or revised Work Flow documents for quality and clinical programs to improve efficiency, accuracy and compliance.
  • In collaboration with the clinical department, facilitate treatment record review process to ensure in compliance with NCQA, URAC, state and Federal standards / regulations.
  • Supervises and evaluates performance of Quality Analyst. Approves leave requests, time sheets and other documents as appropriate. Mentors Quality Analyst to meet professional potential. Monitors performance and conducts timely annual performance appraisals; assesses training needs and coordinates resources to ensure performance and training issues are addressed timely. Keeps department director apprised of staff progress and significant issues and needs.
  • Implement trainings and develop resources for Quality Management staff and other Beacon teams regarding CQI tools and process improvement strategies.
  • Interfaces with external and internal customers to ensure on-going quality improvement activities, accreditation requirements, and prevention programs.
  • Performs special projects and other duties as assigned and required.

Position Requirerments:

  • Education: Master’s degree in Behavioral Health, other relevant industry; or commensurate work experience in managed behavioral health organizations.
  • Licensures: Independent licensure preferred.  License requirement may be waived based on specific market need, Managed Behavioral Healthcare experience, or if the candidate is expected to be obtained within 6 months of hire.  License waiver must be approved by hiring manager and Regional Provider Quality Director.
  • Years and Type of Relevant Work Experience:
    • At least five years’ or more experience in healthcare employing multi-faceted skills in a fast pace environment performed with a large degree of autonomy.
    • Experience in data analysis, quality improvement activities, NCQA strongly preferred.
    • Must be detail-oriented, able to work independently in a flexible environment, able to handle multiple tasks in an efficient manner and have excellent/strong analytical and communication skills both verbal and written.
    • Ability to establish and lead teams, work with multiple constituencies, and develop shared goals is pivotal, along with strong organizational skills.
    • Creative and critical thinking applied to difficult issues and opportunities for improving behavioral healthcare delivery.
    • A proven record of meeting deadlines and managing multiple projects is a must. A client-focus must be demonstrated.

TO APPLY

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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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